Montgomery County Puts the Medicaid Loss at 1,082 Residents Under the New Federal Eligibility Law

Montgomery County health officials gave the County Council a new figure on October 29 for how many residents are affected by a federal law that narrowed Medicaid eligibility for noncitizens starting October 1: 1,082, according to Moderately MoCo's report of the Council's Health and Human Services Committee meeting. A slide shown to the committee said 1,082 specific Montgomery County residents face direct disenrollment risks, and a county health official told the committee those residents no longer have Medicaid.

The figure replaces a rougher estimate in the committee's October 26 staff memo, which put the expected number at approximately 700 to 1,200 county residents and noted the state had not yet provided updated estimates for Montgomery County. The county official described the number as a revision downward, after an initial statewide estimate of 4,500 moved to 3,472.

The coverage losses stem from H.R. 1, the federal budget reconciliation law signed in July 2025, according to the report. Beginning October 1, 2026, the law narrowed the noncitizens who qualify for Medicaid to lawful permanent residents, certain Cuban and Haitian entrants, and citizens of the Marshall Islands, Micronesia and Palau under the Compacts of Free Association.

The same October 29 meeting also covered Care for Kids, the county's health program for uninsured children. A slide from the county health department and the Primary Care Coalition showed enrollment falling from 10,898 in fiscal 2024 to 10,062 in fiscal 2025 to 7,984 in fiscal 2026, with a projected 5,906 in fiscal 2027, according to the report.